Which clinical history is characteristic of papillary thyroid carcinoma (PTC)?

Updated: Jun 18, 2020
  • Author: Ponnandai S Somasundar, MD, MPH, FACS; Chief Editor: Neetu Radhakrishnan, MD  more...
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Answer

The most common presentation of thyroid cancer is an asymptomatic thyroid mass or a nodule that can be felt in the neck. For any patient with a thyroid lump that has developed recently, record a thorough medical history to identify any risk factors or symptoms. In particular, obtain a history regarding every prior exposure to ionizing radiation and the lifetime duration of the radiation exposure. Consider a family history of thyroid cancer.

Some patients with thyroid cancer have persistent cough, difficulty breathing, or difficulty swallowing. Pain is seldom an early warning sign of thyroid cancer. Other symptoms (eg, pain, stridor, vocal cord paralysis, hemoptysis, rapid enlargement) are rare, and can be caused by less serious problems.

At the time of diagnosis, 10-15% of patients with papillary thyroid carcinoma have distant metastases to the bones and lungs. Initially, these patients are evaluated for pulmonary or osteoarticular manifestations (eg, pathologic fracture, spontaneous fracture).


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